HealthCommentary

Exploring Human Potential

Time For Americans To Speak on Health Care Priorities

Posted on | January 11, 2018 | No Comments

Cathy Caldwell, Alabama CHIP

Mike Magee

Of all the developed nations on earth, our’s is the only one with no cogent national plan to support our citizens’ health, productivity and well-being. What we have in its place is an opaque and deeply collusive system of discovery profiteering that has entangled not only industry, but also academic medicine, government agencies like the NIH and FDA, and our elective representatives.

To access profits and career advancement requires a blind eye to transgressions that are, at this point, so obvious and egregious that they carry us all beyond ludicrous. Together we pretend that “defeating disease” as we once defeated the Nazi’s is not only finally within the reach of our brilliant scientists, but an adequate substitution for say – insurance for an everyday kid with a raging ear infection.

If you are Cathy Caldwell, Alabama’s CHIP director, you know the difference. CHIP provides coverage for approximately 9 million kids in the U.S. at a cost of approximately $20 billion a year. It’s part of a patch-work of quick fixes, including the establishment of federal funded community health centers that provide service to 24 million citizens, that are made necessary by our nation’s unwillingness to act in solidarity with each other and embrace universal coverage for our citizens.

The CHIP quick-fix was a series of partial authorizations which have left states like Alabama increasingly in the lurch. For example, Congress’s last 2-year funding provided full funding the first year, but only $5.7 billion the second year. As Caldwell stated recently, “I just do not understand how they even call (the CHIP) patch a half-year of funding. I am trying to get my head around it.” Her program serves 85,000 kids and is administered in partnership with the states BC/BS plan. How are the families involved dealing with the possible near term closure of CHIP? From Caldwell: “I think most are freaked out.”

And yet, you’d never know that from the round of congratulatory back slapping among medical sciences top elite who’s careers are as far removed from the realities of Alabama’s under-class as is humanly possible. No, this week they were all high-fives as Congressional Republicans and Democrats, in overwhelming numbers approved their third consecutive $2 billion increase in the annual NIH budget.

The NIH annual budget now tops $34 billion, enough to keep some 300,000 academic scientists gainfully employed across America. This revenue stream is doubled or tripled or quadrupled by a wide range of contractual relationships with industry with the bounty of patents and royalties being the shared pot of gold at the end of the rainbow.

What does the American public receive in return? Well, that’s hard to say. We don’t even have full access to the results of the studies that our own NIH funded. In 2008, the NIH created the ClinicalTrials.gov database and, in a toothless demand, insisted that studies (positive and negative) be reported out on this open access site. The major academic journals made a great show at the time that they would no longer publish papers who’s results were not listed on ClinicalTrials.gov. But within a year, under the industry threat of lost journal ad revenue, they folded.

Where are we ten years into transparency? Well this week we had a round of congratulatory headlines. Our vaulted academic medical enterprises, self-proclaimed the best in the world, had managed a “C” – reporting out 72% of their trials, and 40% of these were posted years later than required by law. Our FDA and NIH pledge more aggressive oversight but neither have additional staff or funding to support good intentions.

Does reporting matter? Well it did in 2008 when academicians working with GlaxoSmithKline hid clinical evidence that Paxil use in teenagers increased suicidal thoughts and actions. And it did that same year when Dr. Joan Daughton at the U. of Nebraska refused to release results of a study on the use of stimulants in 4 and 5-year-olds who had been labeled by industry marketers and compliant physicians as having ADHD. Other researchers were already picking up permanent neurotransmitter abnormalities in the brains of adults treated with Ritalin in pre-school years. Yet a decade later, the funded results of Daughton’s work have not surfaced in print or online.

The absurdity of all this is why increasingly the elite of the MIC, and their Congressional enablers, find themselves out-of-step with an American public who prioritize universal health care at the top of their list, and not the latest potential yet still to be validated gene cure for inherited blindness in a handful of kids in the U.S. Even if they could come up with the $850,000 per treatment that the company (and its academic partner patent holders) intend to pocket, how does that possibly make up for Cathy Caldwell’s CHIP kids in Alabama?

A health care system built on “defeating disease” is largely fueled by the pursuit of profit, fame and academic power. It should never have been offered as a substitute for a well-planned, equitable, and efficient health delivery system. The time has come to finally get our priorities straight.

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